3 years ago

Achieving Sustained Virologic Response in Liver Transplant Recipients with Hepatitis C Decreases Risk of Decline in Renal Function

Bilal Ali, Sanjaya K. Satapathy, James D. Eason, Miklos Z. Molnar, Humberto C. Gonzalez, Kiran Joglekar, Satheesh P. Nair, Jason M. Vanatta

Abstract

BACKGROUND: The effect of anti‐viral therapy (AVT) on kidney function in liver transplant (LT) recipients has not been well described despite known association of hepatitis C virus (HCV) infection with chronic kidney disease (CKD).

METHODS: We compared the incidence of CKD, and end‐stage renal disease (ESRD) in 204 LT recipients with HCV based on treatment response to AVT.

RESULTS: The median eGFR at baseline (3 months post‐LT) was similar in the SVR (n=145) and non‐SVR group (n=59) (69±21 vs. 65±33 mL/min/1.73 m2, p=0.268). In the unadjusted Cox proportional regression analysis, the presence of SVR was associated with 88% lower risk of CKD (HR: 0.12; 95% CI: 0.05‐0.31), and 86% lower risk of ESRD (OR: 0.14; 95% CI: 0.05‐0.35). Similar result was found after adjustment for propensity score, and time‐dependent Cox regression analyses. The estimated slopes of eGFR based on a two‐stage mixed model of eGFR change revealed patients with SVR had significantly less steep slope than recipients without SVR [−0.60 ml/min/1.73m2/year; 95% CI: −1.50 to +0.30 versus −2.53 ml/min/1.73m2/year; 95% CI: −3.99 to −1.07; p=0.026)].

CONCLUSION: In LT recipients with chronic HCV infection, achieving SVR significantly lowers the risk of decline in renal function and progression to ESRD independent of the AVT therapy used. This article is protected by copyright. All rights reserved.

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